Things have changed drastically for mental health professionals across the country, especially in our area of Westchester County, NY. The rapid spread of Coronavirus (COVID-19) has caused many mental health therapists and other wellness professionals to move their practices to online platforms.
Telehealth for mental health is vastly helpful, but can make specific therapies, such an EMDR Therapy (Eye Movement Desensitization and Reprocessing) a bit trickier.
As with any client, you should always do a full history taking and get a vast layout of the clinical landscape before deciding if EMDR is right for them. For some clients with a history of complex trauma, having a caring, nurturing therapist physically in the room with them makes a world of difference. Therefore, virtual EMDR may not be the way to go for them.
If you and your client have decided that online counseling and EMDR is a good fit, then you can perform the therapy virtually. Note that these tips are for Phase 4 of EMDR (Reprocessing). Before jumping into Phase 4, you should always make sure you've done ample history taking, resourcing and create a a clear target sequence plan and assessment.
1. Make sure you have a HIPAA compliant telehealth system.
I can't stress this enough. For anyone performing online counseling, privacy should always be the top priority for clinicians and their clients. My preferred platform is Simple Practice. (click the link for a 30 day free trial) Simple Practice has an integrated Telehealth feature into their already HIPAA compliant system. The feature I love most about this system is that it involves a screen share option, which brings me to point #2.
2. Screen Share
If the system you are using has a screen share feature, you can easily pull up a virtual lightbar to administer eye movement. There are some virtual lightbars on YouTube that you can pull up. Since the onset of COVID, there are also a number of online programs that you can try which allow you to administer bilateral stimulation, including eye-movements or audio sounds. Some are free, and some require a subscription.
These computer programs allows you to control the speed and duration of each set of BLS (bilateral stimulation).
3. Butterfly Hug
Depending on your client's preference of BLS (bilateral stimulation), also referred to as DAS (Dual Attention Stimulus), you can also guide your clients with the use of the butterfly hug. This is a form of hand tapping, in which the client crosses his/her/their arms over the heart and taps the shoulders in an alternating way.
The Butterfly hug is usually preferred during virtual EMDR because it can often be more grounding for clients, especially for clients with complex trauma.
4. Corners of the Room
Another option if you do not have the ability of a screen share is the corners of the room. This means that you would guide your client to move their eyes from left to right by looking back and forth from the corners of the room they are sitting in. You can also verbally coach them if you need to increase the speed and duration of each set, if needed.
5. Use Your Already Existing Lightbar (if you have one)
This is actually what I do! I have the lightbar from EMDRKit (which I highly recommend, since it's wireless and really easy to use with the app you install on your smart device).
When I am ready to start reprocessing (Phase 4) with a client, I simply put the lightbar right in front of the camera on my computer. Both the lightbar and the client are a comfortable distance so that a full sweep of the eyes is able to be achieved. From there, I control the speed, length and duration of BLS sets right from my smartphone. There's no other software needed, no screen share or separate link you have to send to clients.
For me, it's the easiest and most straightforward way to administer bilateral stimulation for Virtual EMDR Therapy.
As with any therapy, the safety of your client should always be the most important. It's important to make sure there are no contraindications before beginning EMDR Therapy.
If you're unsure of what that would look like, working with an EMDRIA consultant can help.
If you're struggling to successfully use EMDR Virtually in your practice, set up a consultation to learn more about how I can help.
About the Author
Dana Carretta-Stein is a Licensed Mental Health Counselor and founder of Peaceful Living Mental Health Counseling, PLLC, and Carretta Consulting in Scarsdale, NY. She specializes in clinical psychotherapy to treat children, adolescents and adults with anxiety, behavior and trauma difficulties.
She is a certified EMDR therapist and consultant in training in Westchester, NY.
Dana is a business coach for wellness practitioners who are looking to build and grow their private practice.
For more information, visit dana.carretta.com
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